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Diagnosis and Management of Aortic Disease

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58 Treatment 6.5.6.2. Surveillance After AAA Repair COR LOE Recommendations 1 B-NR 1. In patients with AAA treated with EVAR, baseline surveillance imaging with CT is recommended at 1 month postoperatively. If there is no evidence of endoleak or sac enlargement, continued surveillance with duplex ultrasound at 12 months and then annually thereafter is recommended. 2a C-LD 2. In patients with AAA treated with EVAR who are undergoing annual surveillance imaging duplex ultrasound, additional cross-sectional imaging with CT or MRI of the abdomen and pelvis every 5 years postoperatively is reasonable. 2a C-LD 3. In patients with AAA treated with EVAR and abnormal findings (Table 21) on any surveillance duplex ultrasound, additional cross-sectional imaging with CT or MRI is reasonable. 2a C-LD 4. In patients with AAA treated with complex EVAR, a modified surveillance imaging plan that combines cross-sectional imaging and duplex ultrasound of target vessels is reasonable. 2a C-LD 5. In patients with AAA who have undergone open repair, surveillance imaging with CT or MRI of the abdominopelvic aorta within 1 year postoperatively and then every 5 years thereafter is reasonable. Table 21. Abnormal Findings on Duplex Imaging After EVAR That Should Prompt Additional Imaging Aneurysm sac enlargement Any endoleak Stent gra fracture Stent gra migration Stent gra separation

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